scholarly journals Quadratus Lumborum Block Reduces Postoperative Opioid Consumption and Decreases Persistent Postoperative Pain Severity in Patients Undergoing Both Open and Laparoscopic Nephrectomies—A Randomized Controlled Trial

2021 ◽  
Vol 10 (16) ◽  
pp. 3590
Author(s):  
Michał Borys ◽  
Patrycja Szajowska ◽  
Mariusz Jednakiewicz ◽  
Grzegorz Wita ◽  
Tomasz Czarnik ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Pain Management ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Controlled Trial ◽  
Persistent Pain ◽  
Pain Severity ◽  
Randomized Controlled ◽  
Quadratus Lumborum ◽  
Persistent Postoperative Pain

Background: New regional techniques can improve pain management after nephrectomy. Methods: This study was a randomized controlled trial conducted at two teaching hospitals. Patients undergoing elective open and laparoscopic nephrectomy were eligible to participate in the trial. A total of 100 patients were divided into a quadratus lumborum block (QLB) group (50 patients) and a control (CON) group (50 patients). At the end of surgery, but while still under general anesthesia, unilateral QLB with ropivacaine was performed on the side of nephrectomy for patients in the QLB group. The main measured outcome of this study was oxycodone consumption via a patient-controlled anesthesia (PCA) pump during the first 24 h following surgery; other measured outcomes included postoperative pain intensity assessment, patient satisfaction with pain management, and persistent pain evaluation. Results: Patients undergoing QLB needed less oxycodone than those in the CON group (34.5 mg (interquartile range 23 to 40 mg) vs. 47.5 mg (35–50 mg); p < 0.001). No difference between the groups was seen in postoperative pain intensity measured on the visual analog scale, except for the evaluation at hour 2, which was in favor of the QLB group (p = 0.03). Patients who received QLB were more satisfied with postoperative pain management than the CON group. Persistent postoperative pain was assessed with the Neuropathic Pain Symptom Inventory (NPSI) at months 1, 3, and 6, and was found to be significantly lower in the QLB group at each evaluation (p < 0.001). We also analyzed the impact of the surgery type on persistent pain severity, which was significantly lower after laparoscopic procedures than open procedures at months 1, 3, and 6. Conclusions: QLB reduces oxycodone consumption in patients undergoing open and laparoscopic nephrectomy and decreases persistent pain severity months after hospital discharge.

scholarly journals Quadratus lumborum Block Reduces Postoperative Opioid Consumption and Decreases Persistent Postoperative Pain Severity in Patients Undergoing Both Open and Laparoscopic Nephrectomies—a Randomized Controlled Trial

2021 ◽  
Author(s):  
Michal Borys ◽  
Patrycja Szajowska ◽  
Mariusz Jednakiewicz ◽  
Grzegorz Wita ◽  
Tomasz Czarnik ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Pain Management ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Controlled Trial ◽  
Persistent Pain ◽  
Pain Severity ◽  
Randomized Controlled ◽  
Quadratus Lumborum ◽  
Persistent Postoperative Pain

Background: New regional techniques can improve pain management after nephrectomy. Methods: This study was a randomized controlled trial conducted at two teaching hospitals. Patients undergoing elective open and laparoscopic nephrectomy were eligible to participate in the trial. A total of 100 patients were divided into a quadratus lumborum block (QLB) group and a control (CON) group. At the end of surgery, but while still under general anesthesia, unilateral QLB with ropivacaine was performed on the side of nephrectomy for patients in the QLB group. The main measured outcome of this study was oxycodone consumption via a patient-controlled anesthesia (PCA) pump during the first 24 hours following surgery; other measured outcomes included postoperative pain intensity assessment, patient satisfaction with pain management, and persistent pain evaluation. Results: Patients undergoing QLB needed less oxycodone than those in the CON group (34.5 mg [interquartile range 23&ndash;40 mg] vs. 47.5 mg [35&ndash;50 mg]; p&lt;0.001). No difference between the groups was seen in postoperative pain intensity measured on the visual analog scale, except for the evaluation at hour 2, which was in favor of the QLB group (p=0.03). Patients who received QLB were more satisfied with postoperative pain management than the CON group. Persistent postoperative pain was assessed with the Neuropathic Pain Symptom Inventory (NPSI) at months 1, 3, and 6 and was found to be significantly lower in the QLB group at each evaluation (p&lt;0.001). We also analyzed the impact of the surgery type on persistent pain severity, which was significantly lower after laparoscopic procedures than open procedures at months 1, 3, and 6. Conclusions: QLB reduces oxycodone consumption in patients undergoing open and laparoscopic nephrectomy and decreases persistent pain severity months after hospital discharge.

scholarly journals The Effect of Virtual Reality on Anxiety and Pain in Patients Undergoing Gynecological Surgery (VRAP-G); a Randomized Controlled Trial

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Kreijveld BJ ◽  
◽  
Bekkers IPW ◽  
Mulder E ◽  
Wassen MMLH ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Virtual Reality ◽  
Pain Management ◽  
Postoperative Pain ◽  
Standard Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Gynecological Surgery ◽  
Opioid Use ◽  
Randomized Controlled

Background: Lack of postoperative acute pain management is associated with increased morbidity, longer recovery time, more opioid use and subsequently increased health care costs. There is increasing evidence that Virtual Reality (VR) is effective in the reduction of acute pain. Alternative methods to reduce postoperative pain and multimodal analgesia are necessary for acute postoperative pain management and to reduce opioid use and their adverse effects. The aim of this study is to explore the effect of VR on pain in the postoperative period after elective gynecological surgery. Methods and Design: The study concerns a non-blinded, single center, randomized controlled trial. Eligible women fulfilling the inclusion criteria and receive elective gynecological surgery in the Zuyderland Medical Center will be randomized for participation. The study population will be randomly divided into the intervention group (VR-group) or the standard care- group. The intervention group can choose for an immersive guided relaxation VR experience or an interactive VR experience during the pre- and postoperative period additional to the usual standard care. The participants randomized to the standard caregroup will receive only the usual standard care pre-and postoperative. The primary outcome is postoperative pain measured on a Numeric Rating Scale (NRS). A total of 30 patients have to be included in each group. This means that a total of 60 women will have to be included in this study. Secondary outcomes are; evaluating pre-and postoperative anxiety, pain catastrophizing, analgesic use, length of hospital stay between both groups and to explore tolerability, feasibility and satisfaction of VR use. Discussion: This study will provide insight as to whether in women who receive gynecological surgery, VR is an effective method to reduce postoperative pain and subsequently opioid use.

A randomized controlled trial of a peer-led pain management program for older adults: Baseline characteristics and preliminary results

2020 ◽  
Author(s):  
Mimi Mun Yee Tse ◽  
Yajie LI ◽  
Shuk Kwan Tang ◽  
Shamay Sheung Mei Ng ◽  
Xue Bai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Pain Management ◽  
Pain Intensity ◽  
Controlled Trial ◽  
Management Program ◽  
Randomized Controlled ◽  
Pain Management Program ◽  
Pain Knowledge

Abstract Background Chronic pain is common among nursing home residents and they may have difficulty seeking out pain management strategies. Due to the limitation of healthcare resources, peer support model was proved with promising effect in managing chronic conditions. Methods It is a clustered randomized controlled trial. Peer-led pain management program was provided for the experimental group. Pain situation, depression, quality of life, non-drug strategies used and pain knowledge were measured. Results Totally 262 participants joined the study. Their overall pain score was 6.36. Leg was the most frequently reported site of pain and walking ability was interfered. Depression was also reported by the participants. The score for quality of life was 32.65 for physical component and 51.58 for mental component. The mean score for pain knowledge was 46.81 out of 100. No significant difference was shown between two groups at baseline. Discussion Severe pain intensity and low self-efficacy among the participants indicated it is necessary to provide pain management programs especially for this population. The frequency with strategies applied were significantly correlated with pain intensity, pain interference, depression, and quality of life. Pain knowledge also correlated significantly with some strategies.

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